The predictors of acute bacterial meningitis among children presenting as first complex febrile seizure

Abstract

The association between febrile seizure and bacterial meningitis is well established. Although FS induced by age related hyper-excitability of the brain to fever, determining the cause of the fever is critical in the evaluation of these children. It is therefore imperative to rule out BM prior to making the diagnosis of FS. However, the diagnosis of FS in certain subgroups of children with an apparent FS is a challenge: It is mandatory to look for signs of raised intracranial pressure i.e. bulging fontanel, papilloedema and signs of meningeal irritation to exclude meningitis. After approval from the institutional ethics committee, the study was initiated. The parents of children admitted to our institute who were fulfilling the inclusion criteria were informed about this study. Only those patients presenting as first complex febrile seizures are included in the study. Written informed consent from the parents of patients admitted in paediatric wards of Post Graduate Institute of Paediatric Sciences were taken. All cases of ABM had positive CRP compared to the 19% (n=22) cases without bacterial meningitis had positive CRP. Out of total 125 cases, 96.8% (n=122) had negative blood culture, 3.2% (n=4) had positive blood cultures and the blood culture was positive in 3 (33.3%) of ABM cases and 1 (0.8%) with NO ABM. This difference between positive blood culture and ABM was statistically significant.